Medico-economic study of the management of hepatocellular carcinoma by chemo-embolization

“…An economic study has recently shown that TACE with loaded microspheres was globally financially viable despite the higher basic costs of these devices compared to Lipiodol ® and that a ratio of 1.3 sessions (conventional TACE/TACE with microspheres) would enable the new technique to be funded [37]. In practice, conventional TACE is still widely used [38] and the stability of an idarubicin-Lipiodol ® emulsion which has a release profile for the anticancer agent similar to that of the microspheres could lead to a resurgence in the use of the conventional technique [25].…”

Section: Tace With Microspheresmentioning

confidence: 98%

Transarterial chemoembolization for hepatocellular carcinoma: An old method, now flavor of the day

Boulin

Delhom

Pierredon-Foulongne

et al. 2015

Diagnostic and Interventional Imaging

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Transarterial chemoembolization (TACE) is the recommended treatment for patients suffering from intermediate, B stage, hepatocellular carcinoma. Despite an undisputed pharmacokinetic advantage, TACE with microspheres has not been shown to be superior in terms of survival compared to conventional TACE using Lipiodol(®). The best guarantee to reduce toxicity and maximize the efficacy of TACE is to strictly observe the contraindications for the procedure (Child-Pugh>B8, reduced portal flow, very large tumor, any technical contraindication and renal impairment), and rigorous application of the administration requirements for the Lipiodol(®) emulsion or loaded microspheres (assessment of hepatic vascularization investigating for accessory vascularization, injection methods). Tumor response should be assessed after four weeks by CT or MRI using the modified RECIST criteria.

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“…It is routinely used in French economic evaluations to assess hospital production costs. [27][28][29] Finally, cost data from the SHI were used to calculate hospital revenue using DRG tariffs in addition to tariffs for daily supplements and other modifiers. 30…”

Section: Data Sourcesmentioning

confidence: 99%

Socioeconomic Status of Newborns and Hospital Efficiency: Implications for Hospital Payment Methods

et al. 2020

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Objectives: Studies have shown a consistent impact of socioeconomic status at birth for both mother and child; however, no study has looked at its impact on hospital efficiency and financial balance at birth, which could be major if newborns from disadvantaged families have an average length of stay (LOS) longer than other newborns. Our objective was therefore to study the association between socioeconomic status and hospital efficiency and financial balance in that population.Methods: A study was carried out using exhaustive national hospital discharge databases. All live births in a maternity hospital located in mainland France between 2012 and 2014 were included. Socioeconomic status was estimated with an ecological indicator and efficiency by variations in patient LOS compared with different mean national LOS. Financial balance was assessed at the admission level through the ratio of production costs and revenues and at the hospital level by the difference in aggregated revenues and production costs for said hospital. Multivariate regression models studied the association between those indicators and socioeconomic status.Results: A total of 2 149 454 births were included. LOS was shorter than the national means for less disadvantaged patients and longer for the more disadvantaged patients, which increased when adjusted for gestational age, birth weight, and severity. A 1% increase in disadvantaged patients in a hospital's case mix significantly increased the probability that the hospital would be in deficit by 2.6%.Conclusions: Reforms should be made to hospital payment methods to take into account patient socioeconomic status so as to improve resource allocation efficiency.

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Medico-economic study of the management of hepatocellular carcinoma by chemo-embolization

Abstract: This medico-economic analysis demonstrates that the TACE-DEB procedure is fundable.

Cited by 10 publications

References 7 publications

Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument

Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument

Transarterial chemoembolization for hepatocellular carcinoma: An old method, now flavor of the day

Socioeconomic Status of Newborns and Hospital Efficiency: Implications for Hospital Payment Methods

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